Anxiety and depression.

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Mental health problems in young children can have important implications for their development. It is important to understand the causes, symptoms, effects and best intervention practices to recognize and prevent anxiety and depression in young children.

Anxiety and depression can be hard to detect and diagnose in young children but these problems can start as young as the toddler years. Anxious or depressed children may appear very shy, tend to avoid social contacts and withdraw from or overreact to unfamiliar situations. They may exhibit intense sadness, fears and worries and have problems eating and sleeping. These problems can lead to low self-confidence, lack of social skills and risk of peer rejection as they develop. Parents and caregivers need to pay attention to these early signs in order to help children overcome the long term negative impact of emotional problems.

*How important is it? Mental health problems experienced in begin in childhood and adolescence. It is estimated that 1 in 7 children suffer from mental health problems worldwide. One of the major types of mental health issues found in childhood is internalizing problems. Internalizing problems are characterized by emotional distress turned inward, which makes these problems difficult to recognize. Unlike normal fear, shyness and sadness, internalizing problems impair a young child’s functioning and development.

Internalizing problems include depression and anxiety. Symptoms of depression in older children include feelings of sadness, eating/weight problems, sleep disturbance, loss of energy and low self-esteem. *What do we know? young children to explain how they feel. Fortunately, new innovative methods such as puppet interviews and picture tests have been used to help children express their emotions. The first signs of internalizing problems are often observed in the peer group, where depression and anxiety can manifest themselves as self-consciousness, fearfulness, preoccupation and nervousness. Children with internalizing problems often struggle with initiating contact or conversation, talk very little and make infrequent eye contact. These socially withdrawn behaviours make them more likely to be victimized by peers. The friendships of anxious or depressed children also tend to be less frequent, of poorer quality, and with children who also display internalizing problems, which can worsen existing problems. However, having at least one close friend can also protect a child from some of the detrimental effects of internalizing problems. appears to be a consistent risk in the development of internalizing problems. Children of mothers who are overprotective, overcritical or use harsh discipline tend to have poor emotion regulation skills and are more susceptible to emotional health difficulties. Parents who are themselves anxious can also put children at risk for anxiety disorders by modeling avoidant or anxious behaviours. The effects of these parenting behaviours are especially strong for children with behavioural inhibition.

Poor attachment is another risk factor for the development of anxiety and depression.

*What can be done? An initial necessary step in understanding the development of childhood depression and anxiety is to expand assessment of these conditions in the clinical and research setting through multi-method, multi-session and multi-informant techniques. While including a screening for internalizing problems during standard check-ups might be ideal, targeting at risk children and families may represent a more cost-efficient and realistic method to prevent or reduce negative consequences associated with internalizing problems. For instance, accurate screening in locations where children are at risk for experiencing trauma (e.g., hospitals) or identifying children who are behaviourally inhibited at an early age can have a major impact on children, their families and society at large. *What can be done? While including a screening for internalizing problems during standard check-ups might be ideal, targeting at risk children and families may represent a more cost-efficient and realistic method to prevent or reduce negative consequences associated problems. For instance, accurate screening in locations where children are at risk for experiencing trauma (e.g., hospitals) or identifying children who are behaviourally inhibited at an early age can have a major impact on children, their families and society at large. behavioural therapy is the most common and effective method to treat anxiety and depression in childhood.focuses on helping children identify and confront their own distorted thinking habits and involves behavioural techniques that gradually expose children to anxiety-provoking situations. Play-based has been used with children as young as 4 years of age.

Involving parents in treatment is beneficial in reducing symptoms of depression and anxiety.

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